George E. Ehrlich, MD
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Ehrlich GE. Blinding in Placebo-Controlled Trials. Ann Intern Med. 2001;134:1150-1151. doi: 10.7326/0003-4819-134-12-200106190-00020
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Published: Ann Intern Med. 2001;134(12):1150-1151.
TO THE EDITOR:
In his editorial (1) commenting on a controlled study that supported the efficacy of zinc lozenges as treatment for the symptoms of the common cold (2), Dr. Desbiens suggested that the skewed ratios of patients who believed they had received the treatment and those who correctly believed they had received placebo or those who were not sure could have indicated that there were, after all, detectable differences between the two lozenges. But that assumption would be valid only if this had been a crossover study. Because patients taking the lozenges had no comparative factors on which to base their guesses, I accept the authors' assertion that chance alone accounted for the differences. However, it remains remotely possible that the disease period was shortened by patients' belief that they received treatment. If so, the skewed ratios would have worked in favor of zinc lozenges on the basis of the participants' faith, since only 13% of patients receiving placebo believed they had been given zinc and three times as many patients receiving zinc believed the same. Faith, optimism, well-being, and contentment seem to play a major confounding role in our assessment of disease course, as recent articles in Annals and other major journals have concluded.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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